Alternaria keratitis and hypopyon after clear-cornea phacoemulsification

Area of Science:

• Ophthalmology
• Infectious Diseases

Background:

• A 66-year-old woman developed a painful red eye months after clear-corneal cataract surgery.
• The condition was unresponsive to standard antibiotic and corticosteroid treatments.

Observation:

• Examination revealed a dense corneal infiltrate at the incision site and a 2.0 mm hypopyon.
• Corneal scrapings identified Alternaria species as the causative agent.

Findings:

• Treatment involved topical/subconjunctival amphotericin-B and oral ketoconazole.
• Complete resolution of keratitis and hypopyon occurred within 30 days.
• No recurrence was noted during a 6-year follow-up period.

Implications:

• This is the first reported case of Alternaria keratitis following clear-corneal cataract surgery.
• The study highlights the effectiveness of amphotericin-B and ketoconazole in treating this specific fungal infection.
• Early diagnosis and targeted antifungal therapy are crucial for managing post-cataract surgery fungal keratitis.